Objective: To observe the short-term effects of irbesartan treatment on microalbuminuria in patients with normotensive type 2 diabetes.
Methods: A total of 40 normotensive type 2 diabetes patients (mean age 55.1+/-11.4 years) who had microalbuminuria were included in this non-comparative and prospective research study. The study took place in Ege University Hospital, Bornova-Izmir, Turkey, between January 2005 and April 2005. Patients were treated with irbesartan 300mg/day for 3 months. Physical examination, medical history, systolic and diastolic blood pressure levels, microalbuminuria, diabetes markers fasting and non-fasting blood glucose, glycosylated hemoglobin [HbA1c], lipid profile, creatinine and urea were obtained at baseline and after 3 months of irbesartan treatment. The primary assessment criterion was the change in microalbuminuria.
Results: The mean microalbuminuria level at baseline was 110.8+/-93.1mg/24 hours. It significantly decreased to 45.6+/-62.5mg/24 hours at the end of 3 months of irbesartan treatment (p<0.001). When patients were stratified according to the change in the microalbuminuria status after treatment, 90% of them either returned to normo albuminuria or their microalbuminuria decreased. Both diastolic and systolic blood pressures, fasting and non-fasting blood glucose, and HbA1c were found to be significantly decreased after 3 months of irbesartan treatment compared to pre-treatment values. The positive effect of irbesartan on microalbuminuria occurs independently from HbA1c, fasting blood glucose, and blood pressures.
Conclusion: The short-term treatment of irbesartan is effective to decrease microalbuminuria in normotensive type 2 diabetes patients, independent of its antihypertensive effect. There is a need for multicenter prospective studies to investigate this further.